Because the range of bowel habits and stool types in the community is unknown we questioned 838 men and 1059 women, comprising 72.2% of a random stratified sample of the East Bristol population. Most of them kept records of three consecutive defecations, including stool form on a validated six point scale ranging from hard, round lumps to mushy. Questionnaire responses agreed moderately well with recorded data. Although the most common bowel habit was once daily this was a minority practice in both sexes; a regular 24 hour cycle was apparent in only 40% of men and 33% of women. Another 7% of men and 4% of women seemed to have a regular twice or thrice daily bowel habit. Thus most people had irregular bowels. A third of women defecated less often than daily and 1% once a week or less. Stools at the constipated end of the scale were passed more often by women than men. In women of child bearing age bowel habit and the spectrum of stool types were shifted towards constipation and irregularity compared with older women and three cases of severe slow transit constipation were discovered in young women. Otherwise age had little effect on bowel habit or stool type. Normal stool types, defined as those least likely to evoke symptoms, accounted for only 56% of all stools in women and 61% in men. Most defecations occurred in the early morning and earlier in men than in women. We conclude that conventionally normal bowel function is enjoyed by less than half the population and that, in this aspect of human physiology, younger women are especially disadvantaged.

https://gut.bmj.com/content/gutjnl/33/6/818.full.pdf

Defecation frequency and timing, and stool form in the general population: a prospective study.

https://www.gastrojournal.org/article/0016-5085(92)91435-7/pdf

Fecal weight, colon cancer risk, and dietary intake of nonstarch polysaccharides (dietary fiber)

This is a prospective study of breast cancer risk in relation to nipple aspirate fluid cytology in 2,701 volunteer white women from the San Francisco Bay Area first enrolled between 1973 and 1980. The women were not pregnant or lactating and were free of breast cancer within 6 months of entry into the study. The breast cancer status of this cohort was determined between June 1988 and April 1991. Follow-up was complete for 87% (n = 2,343) of the cohort, representing 29,961 person-years and an average of 12.7 years of follow-up. The overall breast cancer incidence was 4.4% (104 of 2,343) and rose with fluid cytology findings as follows: no fluid obtained, 2.6% (9 of 352); unsatisfactory specimen, 4.8% (15 of 315); normal cytology, 4.3% (56 of 1,291); epithelial hyperplasia, 5.5% (18 of 327); and atypical hyperplasia, 10.3% (6 of 58). Relative risks for breast cancer and their 95% confidence intervals were estimated by Cox regression, adjusting for age and year of entry. Compared with the relative risk for women who yielded no fluid, relative risks were: unsatisfactory specimen, relative risk (RR) = 1.4 (95% confidence interval (CI) 0.6-3.3); normal cytology, RR = 1.8 (95% CI 0.9-3.6); epithelial hyperplasia, RR = 2.5 (95% CI 1.1-5.5); and atypical hyperplasia, RR = 4.9 (95% CI 1.7-13.9). These findings were strongest for and were mainly confined to women aged 25-54 years. Women with atypical hyperplasia and a first-degree family history of breast cancer were six times more likely to develop breast cancer than were women with atypical hyperplasia but without a family history of breast cancer (95% CI 1.0-30.2). These findings provide strong support for our hypothesis that hyperplasia and atypical hyperplasia diagnosed in nipple aspirates of breast fluid are associated with an increased risk of breast cancer.

Breast Cancer Incidence in Women with Abnormal Cytology in Nipple Aspirates of Breast Fluid

Evidence from epidemiological studies suggests that dietary fiber, as well as fat, has the potential for affecting breast cancer risk. Fiber may have a protective role because of its influence on estrogen metabolism and excretion or because of the endocrine effects of the lignans, a family of compounds formed in the intestine from fiber‐associated precursors. Future research should include additional mechanistic studies and dietary intervention trials in groups of women that have a high risk of breast cancer.

Dietary fiber and breast cancer

Studies of cytologic and biochemical constituents of nipple aspirates of breast fluid have contributed to understanding the natural history of benign and malignant breast disease. We conducted multivariate analyses using 1428 women from a recent case-control study of breast disease to determine which factors were independently associated with the ability to obtain breast fluid from nonlactating women. We then compared results from these analyses to the results from five previous studies that also used the aspiration technique of Sartorius. Four factors were consistently associated across studies with increased ability to obtain breast fluid: 1) age up to 35 to 50 years; 2) earlier age at menarche; 3) non-Asian compared to Asian ethnicity; and 4) history of lactation. Exogenous estrogen use, endogenous estrogen concentrations, phase of menstrual cycle, family history of breast cancer, type of menopause, and less than full-term pregnancy consistently did not influence ability to obtain fluid. New findings from this study shed light on some apparently contradictory findings from the previous studies. In particular, this study showed that the effects of age on ability to obtain fluid appeared to be independent of the effects of menopause. Furthermore, discrepancies in previous findings on the effects of parity on ability to obtain fluid may be explained by our finding that the increased ability to obtain fluid from parous compared to nulliparous women applied only to parous women who had breastfed.

Factors associated with obtaining nipple aspirate fluid: analysis of 1428 women and literature review.

Cytological abnormalities in nipple aspirates of breast fluid from women with severe constipation.

Characterization by image cytometry of duct epithelial proliferative disease of the breast.

Prognostic significance of atypical epithelial hyperplasia in nipple aspirates of breast fluid.

We used image cytometry to classify benign and malignant breast lesions, to identify parameters that classify premalignant lesions, and to assess these parameters for a biological association that may be linked with malignancy. Results suggest that quantitative image analysis is able to discriminate ''normal'' from ''abnormal'' breast lesions. Thus image cytometry may provide an objective approach for early detection of malignant changes in the breast. The parameters selected by stepwise discriminant and regression analyses as being most useful for discriminating among breast lesions relate to nuclear size, shape and DNA content. These parameters are robust and easily measured and are similar to those used by others for discriminating benign from malignant lesions. Significantly, no parameter based on nuclear chromatin distribution ranked as highly in this study, unlike our experience with studies of other premalignant lesions. 9 refs., 1 fig., 3 tabs.

Image cytometry of duct cells from benign and malignant breast disease

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Cytological abnormalities in nipple aspirates of breast fluid from women with severe constipation.

Characterization by image cytometry of duct epithelial proliferative disease of the breast.

Prognostic significance of atypical epithelial hyperplasia in nipple aspirates of breast fluid.

Image cytometry of duct cells from benign and malignant breast disease